Academic literature on the topic 'Karnofsky performance scale (KPS)'

e24035 Background: The use of performance status (PS) assessments in patients with cancer is a common practice to determine their suitability for treatment, clinical trial enrollment, and prognosis. The Karnofsky Performance Scale (KPS) and Eastern Cooperative Oncology Group Performance Status (ECOG PS) score are widely used clinical instruments for this purpose. However, these tools are subjective and unidimensional, with potential for bias, and were validated in younger patients. KPS has demonstrated greater specificity than ECOG in evaluating PS. Frailty, a dynamic medical syndrome characterized by diminished strength, endurance, and reduced physiological function, is recognized as a predictor of vulnerability to adverse outcomes, especially in older adults with cancer. The Fried Frailty Phenotype (FP) is a widely validated tool that uses both objective and subjective measures to identify frailty based on presence of 3 or more criteria: unintentional weight loss, self-report of exhaustion (fatigue), weakness (measured by grip strength), slow walking speed, and low physical activity. Our study compares physician-rated KPS with FP (fit, prefrail, frail) and looks at correlation of both tools in older adults with cancer. Methods: Data from older adults with solid tumor malignancies referred to the geriatric oncology clinic for geriatric assessment (GA) from January 2015–August 2019 were abstracted. Physician-rated KPS (0-100) were categorized into 3 groups: normal activity, high functioning (80–100); intermediate, capable of self-care but unable to do active work (70); and poor PS, requires considerable assistance (<60). These were compared to FP which classified patients based on the number of frailty criteria present: fit (0), prefrail (1-2), and frail (>3). Frequency data calculation and bivariate analysis were done. Results: 241 older adults with cancer completed a GA, median age of 80 years, 52% female. 57% were frail, 37% prefrail, and 6% fit. 90% of patients with KPS 80-100, had prefrail and frail phenotypes. Patients with KPS 70 had 24% prefrail and 76% frail phenotypes and those with KPS < 60 had 10% prefrail and 90% frail phenotypes. Conclusions: Majority of older patients with prefrail and frail phenotypes were assessed as high functioning (KPS 80-100). KPS is an inadequate substitute for FP and should not be used alone in assessing functional status of older adults with cancer.

Abstract Gliomas are one of the most common primary brain tumors. MicroRNA-21 (miRNA-21) has been shown in previous studies to be associated with prognosis in glioma patients. However, similar studies in the Asian population, particularly in Indonesia, are very limited. This study aimed to find the association of plasma miRNA-21 expression with functional status measured by Karnofsky Performance Scale (KPS) in Indonesian glioma patients. The patients were enrolled from a neuro-oncology referral center in Yogyakarta, Indonesia. MiRNA-21 expression from plasma was measured by real-time quantitative PCR. Clinical data were obtained from medical records. KPS scores were classified as low (< 70) and high (> 70). In total, 50 patients were included in this study. Most patients were diagnosed with WHO grade IV gliomas (30.4%), followed by grade II (30.4%), grade III (21.4%), and grade I (5.4%). Most patients (64%) have low KPS scores (< 70). Patients in the low KPS scores group have significantly higher miRNA-21 expression compared to patients in the high KPS scores group (2-∆CT 4.26 vs. 0.68, p=0.002). In conclusion, higher expression of plasma miRNA-21 is associated with worse functional status in glioma patients as measured by KPS.

Background: Elevated pulmonary serum adenosine deaminase (ADA) levels signify lung tissue damage and severe tuberculosis (TB). Serum ADA assays can be used as an additional criterion for assessing TB treatment response and as a prognostic marker in patients with pulmonary TB. The Bandim TB and Karnofsky Performance Scale (KPS) scores were developed based on available clinical data and investigations to allow physicians to evaluate disease treatment and response. This study examined the use of a clinical scoring system (Bandim TB and KPS scores) in the context of serum ADA activity.Methods: Forty adults (aged >18 years) diagnosed with pulmonary TB by Ziehl-Neelsen staining for acid-fast bacilli and/or cartridge-based nucleic acid amplification test were recruited. Standardized questionnaires were used to record Bandim TB and KPS scores. Serum ADA levels were estimated using a commercial kit.Results: The Bandim TB score was positively associated (ρ=0.74, P≤0.001) and the KPS score was negatively associated (ρ=-0.69, P≤0.001) with serum ADA levels.Conclusion: Subjective and objective clinical scores of pulmonary TB were strongly correlated with serum ADA levels. Knowledge of clinical scores corresponding to serum ADA levels could help physicians understand stage and progression of the disease which may aid in early detection and better management, and reduce disease transmission in a TB-endemic country.

Introduction: Patients with tumor usually show abnormal laboratory coagulation tests, indicating a subclinical hypercoagulable state that contributes to morbidity and mortality. Hematologic markers such as the platelet-lymphocyte ratio (PLR) can be used as an index of tumor progression, high PLR is associated with morbidity and mortality in patients with primary or metastatic tumors. KPS is a method that is widely used to assess the functional status of a patient. The aim of this study is to determine the relationship between coagulation profile and platelet-lymphocyte with Karnofsky Performance Status Scale in Brain Tumor Patients. Method: This study was an observational analytic study with a cross-sectional design using primary data sources taken consecutively from all brain tumor patients who were hospitalized in Inpatient Room at Haji Adam Malik General Hospital Medan who met the inclusion criteria. The parameters analyzed were Prothrombin Time (PT), Activated Partial Thromboplastin Time (aPTT), D dimer (DD), and PLR. Clinical outcome of brain tumor patients was assessed using KPS. To assess the relationship between coagulation marker factors and the ratio of platelets to lymphocytes to KPS, the Spearman and Gamma tests were used. Results: Of the 30 research subjects analyzed, the number of female subjects was comparable to that of males (50%). The highest age is in the age range of 61-70 years by 30%. The highest level of education was high school at 40%, the most research subjects were housewives at 33.3% and the most types of brain tumors were primary brain tumors at 56.7%. The highest KPS score during treatment was found in the <70 group of 76.7%. From the correlation test, it was found that there was a strong, significant relationship between the values of PT (p<0.02 r = -0.731), APTT (p<0.013 r = -0.761), D-dimer (p<0.001 r = -0.737) and PLR (p<0.001 r = 0.78) on the clinical outcome of brain tumor patients assessed by KPS. Conclusion: There is a strong relationship between PT, APTT, D-dimer and PLR values on KPS in patients with brain tumor.

<strong>ABSTRACT</strong> The purpose of this study is to evaluate the functional outcome in cases of penetrating brain injuries using Karnofsky performance scale (KPS). This prospective study was conducted to include 47 patients subjected to penetrating brain injury and admitted to the Emergency Department (ED) of Alexandria Main University Hospital from March 2014 to February 2016. Primary survey and secondary survey done for those patients, radiological investigations done including CT brain and other radiological investigations to exclude associated injuries (thoracic, abdominal injuries). 27 patients (57.5 %) died and 20 patients (42.5 %) survived. 17 patients (36.2%) got KPS A, 3 patients (6.4%) got KPS B and 27 patients (57.4%) got KPS C. Many predictors of the functional outcome of the patients are discussed as age, sex, mode of trauma, SBP, MGAP score and CT brain findings. <strong>Key words:</strong> penetrating traumatic brain injury (pTBI) , karnofsky performance scale&nbsp; (KPS)&nbsp;&nbsp;&nbsp; <strong>REFERENCES&nbsp;</strong> Aarabi B, Mossop C, Aarabi J. Surgical Management of civilian gunshot wounds to the head. Handb Clin Neurol 2015; 127: 181-93. Aarabi B, Tofighi B, Kufera JA, Hadley J, Ahn ES, Cooper C, et al. Predictors of outcome in civilian gunshot wounds to the head. J Neurosurg 2014; 120:1138-46. Ahun E, K&ouml;ksal &Ouml;, Sığırlı D, Torun G, D&ouml;nmez SS, Armağan E. The mortality of major trauma patients presenting to the emergency department. Ulus Travma Acil Cerrahi Derg 2014; 20(4):241-7. Ambrosi PB, Valen&ccedil;a MM, Azevedo-Filho H. Prognostic factors in civilian gunshot wounds to the head: a series of 110 surgical patients and brief literature review. Neurosurg Rev 2012; 35(3): 429-35. Folio L, Solomon J, Biassou N, Fischer T, Dworzak J, Raymont V, et al. Semi-automated trajectory analysis of deep ballistic penetrating brain injury. Mil Med 2013; 178(3): 338-45. Porika Raju and Estari Mamidala (2015). Anti-diabetic activity of compound isolated from Physalis angulata fruit extracts in alloxan induced diabetic rats. The Ame J Sci &amp; Med Res, 2015,1(1); Pages 1 -6. doi:10.17812/ajsmr2015.11.1 Granacher RP. Traumatic Brain Injury: Methods for Clinical &amp; Forensic Neuropsychiatric Assessment. 2nd ed. Boca Raton: CRC Press; 2007. 26&ndash;32. Karnofsky DA, Burchenal JH. The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod CM (ed). Evaluation of chemotherapeutic agents. New York: Columbia University Press; 1949. 191&ndash;205. Kim KA, Wang MY, McNatt SA, Pinsky G, Liu CY, Giannotta SL, et al. Vector analysis correlating bullet trajectory to outcome after civilian through-and-through gunshot wound to the head: using imaging cues to predict fatal outcome. Neurosurgery 2005; 57:737&ndash;47. Kondo Y, Abe T, Kohshi K, Tokuda Y, Cook EF, Kukita I. Revised trauma scoring system to predict in-hospital mortality in the emergency department: Glasgow Coma Scale, Age, and Systolic Blood Pressure score. Crit Care 2011;15:R191. Nirula R, Maier R, Moore E, Sperry J, Gentilello L. Scoop and run to the trauma center or stay and play at the local hospital: hospital transfer&rsquo;s effect on mortality. J Trauma 2010; 69:595-601. Rehn M, Perel P, Blackhall K, Lossius HM. Prognostic models for the early care of trauma patients: a systematic review. Scand J Trauma Resusc Emerg Med 2011; 19:17. Roberts I. Tranexamic acid in trauma: how should we use it? J Thromb Haemost 2015; 13 Suppl 1: S195-9. Saatman KE, Duhaime AC, Bullock R, Maas AI, Valadka A, Manley GT. Classification of traumatic brain injury for targeted therapies. J Neurotrauma 2008; 25(7): 719-38.

Objective:The objective of this study was to document the impact of the preoperative Karnofsky Performance Scale (KPS) and American Society of Anesthesiologists (ASA) scores on perioperative complications in patients with recurrent glioma who underwent tumor resection via craniotomy.Methods:A total of 96 patients were retrospectively reviewed. Based on KPS and ASA scores, patients were categorized into high KPS (&gt; 70) or low KPS (≤ 70) and high ASA (3~4) or low ASA (1~2) groups. Differences in intraoperative risk factors and perioperative complications among the groups were analyzed. Multivariate analysis was performed to identify risk factors for perioperative complications.Results:The most frequent perioperative complications were cerebrospinal fluid leakage (31.8%) and intracranial infection (27.0%); 30-day mortality was 5.2%. The incidence rates of severe complications, central nervous system complications, and total complications were comparable in the low and high KPS groups and in the low and high ASA groups (all p &gt; 0.05). Multivariate analysis showed that low KPS and high ASA scores were not the independent risk factors for perioperative complications.Conclusion:Low KPS and high ASA scores are not associated with increased postoperative complications in patients with recurrent glioma who undergo tumor resection via craniotomy.

Background: Accurate assessment and evaluation of health interventions are crucial to evidence-based care. The use of outcome measures in neurosurgery grew with the introduction of the Glasgow Coma Scale. Since then, various outcome measures have appeared, some of which are disease-specific and others more generally. This article aims to address the most widely used outcome measures in three major neurosurgery subspecialties, “vascular, traumatic, and oncologic,” focusing on the potential, advantages, and drawbacks of a unified approach to these outcome measures. Methods: A literature review search was conducted by using PubMed MEDLINE and Google scholar Databases. Data for the three most common outcome measures, The Modified Rankin Scale (mRS), The Glasgow Outcome Scale (GOS), and The Karnofsky Performance Scale (KPS), were extracted and analyzed. Results: The original objective of establishing a standardized, common language for the accurate categorization, quantification, and evaluation of patients’ outcomes has been eroded. The KPS, in particular, may provide a common ground for initiating a unified approach to outcome measures. With clinical testing and modification, it may offer a simple, internationally standardized approach to outcome measures in neurosurgery and elsewhere. Based on our analysis, Karnofsky’s Performance Scale may provide a basis of reaching a unified global outcome measure. Conclusion: Outcome measures in neurosurgery, including mRS, GOS, and KPS, are widely utilized assessment tools for patients’ outcomes in various neurosurgical specialties. A unified global measure may offer solutions with ease of use and application; however, there are limitations.

Metastases are the most frequent intracranial malignant tumors in adults. While Karnofsky Performance Status (KPS) and Clinical Frailty Scale (CFS) are known to have significant impact on overall survival (OS), temporal muscle thickness (TMT) has been postulated to be a promising new parameter to estimate prognosis. Patients who received a resection of one to three brain metastases in our institution were included. Temporal muscle thickness was measured in preoperative MRI scans according to a standardized protocol. In 199 patients, the mean TMT was 7.5 mm (95CI 7.3–7.7) and the mean OS during follow-up was 31.3 months (95CI 24.2–38.3). There was no significant correlation of TMT and preoperative or follow-up CFS and KPS. While CFS and KPS did significantly correlate with OS (p &lt; 0.001 for each), no correlation was demonstrated for TMT. CFS showed a superior prognostic value compared to KPS. TMT failed to show a significant impact on OS or patient performance, whereas the clinical scales (KPS and CFS) demonstrate a good correlation with OS. Due to its superiority over KPS, we strongly recommend the use of CFS to estimate OS in patients with brain metastases.

Object The object of this study was to determine the benefit of surgery, radiation, and chemotherapy for patients with glioblastoma multiforme (GBM) and a low Karnofsky Performance Scale (KPS) score. Methods The authors retrospectively evaluated the records of patients who underwent primary treatment for pathologically confirmed GBM and with a KPS score ≤ 50 on initial evaluation for radiation therapy at a tertiary care institution between 1977 and 2006. Seventy-four patients with a median age of 69 years (range 19–88 years) and a median KPS score of 50 (range 20–50) were retrospectively grouped into the Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis (RPA) Classes IV (11 patients), V (15 patients), and VI (48 patients). Patients underwent biopsy (38 patients) or tumor resection (36 patients). Forty-seven patients received radiation. Nineteen patients also received chemotherapy (53% temozolomide), initiated concurrently (47%) or after radiotherapy. Results The median survival overall was 2.3 months (range 0.2–48 months). Median survival stratified by RPA Classes IV, V, and VI was 6.6, 6.6, and 1.8 months, respectively (p &lt; 0.001, log-rank test). Median survival for patients receiving radiation (5.2 months) was greater than that for patients who declined radiation (1.6 months, p &lt; 0.001). Patients in RPA Class VI appeared to benefit from radiotherapy only when tumor resection was also performed. The median survival from treatment initiation was greater for patients receiving chemotherapy concomitantly with radiotherapy (9.8 months) as compared with radiotherapy alone (1.7 months, p = 0.002). Of 20 patients seen for follow-up in the clinic at a median of 48 days (range 24–196 days) following radiotherapy, 70% were noted to have an improvement in the KPS score of between 10 and 30 points from the baseline score. On multivariate analysis, only RPA class (p = 0.01), resection (HR = 0.37, p = 0.001), and radiation therapy (HR = 0.39, p = 0.02) were significant predictors of a decreased mortality rate. Conclusions Patients with a KPS score ≤ 50 appear to have increased survival and functional status following tumor resection and radiation. The extent of benefit from concomitant chemotherapy is unclear. Future studies may benefit from reporting that utilizes a prognostic classification system such as the RTOG RPA class, which has been shown to be effective at separating outcomes even in patients with low performance status. Patients with GBMs and low KPS scores need to be evaluated in prospective studies to identify the extent to which different therapies improve outcomes.

Submitted by Sandra Mendonça (sandra.mendonca@unioeste.br) on 2019-03-11T13:44:56Z No. of bitstreams: 2 Cinthya_Raquel_2018.pdf: 1923643 bytes, checksum: aee0d6b6e9ac7931be835a7558cfe622 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)<br>Made available in DSpace on 2019-03-11T13:44:56Z (GMT). No. of bitstreams: 2 Cinthya_Raquel_2018.pdf: 1923643 bytes, checksum: aee0d6b6e9ac7931be835a7558cfe622 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-11-27<br>Clinical management of cancer patients involves primarialy the recovering of their biological health. This process is accompained by a psycosocial context, since cancer patients undergoing treatment fight profound bad feelings as pain, suffering, mutilation, destruction and death. Therefore, it is necessary to profoundly understand this patient, especially regarding the caracteristics that contribute to the mainentance and improvement of their quality of life. In this context, few instruments have been associated to evaluate the quality of life of patients ongoing chemotherapy, as well as it is not clear which specific component of such instruments influence the global health status of such patients.In the present study, we evaluated the relationship between the functional capacity and quality of life of cancer patients submitted to chemotherapy in a public health hospital from Brazil. To reach this goal, we used the Karnofsky performance scale and the EORTC QLQ-30 questionnaire as predictors of global health in patients with cancer. A total of 101 patients were enrolled in the study, from June to December 2017. All data were categorized accordingly and analyzed in SPSS 22.0.0 software for possible association among parameters. Patients presented a mean age of 59,6±13 years, and were predominatly female. Breast cancer was the most common neoplasia (43.56%), and most of patients exhibited advanced disease (73%) and distant metastasis (66.33%) at diagnosis. The global health score evaluated by EORTC QLQ-30 was 67.5%, and about 63% of patients presented a Karnofsky status of 80%. The most positive influent factor on the functional capacity was the working function (R = 0.515, p<0.05). Further, emotional and social functions were strongly associated with the global health status of patients (R = 0,960, p<0,05). Our data showed that the Karnofsky performance scale is a great tool for evaluating the quality of life in cancer patients undergoing chemotherapy, which correlates positively with their global health scores and is affected by emotional and social functions of patients.<br>O manejo clínico de pacientes com câncer envolve primariamente a recuperação de sua saúde biológica. Esse processo é acompanhado por um contexto psicossocial, uma vez que os pacientes oncológicos em tratamento combatem sentimentos ruins como dor, sofrimento, mutilação, destruição e morte. Portanto, é necessário entender profundamente esse paciente, principalmente no que se refere às características que contribuem para a manutenção e melhora da qualidade de vida. Nesse contexto, poucos instrumentos têm sido associados para avaliar a qualidade de vida dos pacientes em tratamento quimioterápico, assim como não está claro qual componente específico de tais instrumentos influencia o estado global de saúde desses pacientes. No presente estudo, avaliamos relação entre a capacidade funcional e a qualidade de vida de pacientes com câncer submetidos à quimioterapia em um hospital público de saúde do Brasil. Para atingir esse objetivo, utilizamos a escala de desempenho de Karnofsky e o questionário EORTC QLQ-30 como preditores de saúde global em pacientes com câncer. Um total de 101 pacientes foram incluídos no estudo, de junho a dezembro de 2017. Todos os dados foram categorizados de acordo e analisados no software SPSS 22.0.0 para possível associação entre os parâmetros. Os pacientes apresentavam idade média de 59,6 ± 13 anos e eram predominantemente do sexo feminino. O câncer de mama foi a neoplasia mais comum (43,56%) e a maioria dos pacientes apresentou doença avançada (73%) e metástase à distância (66,33%) ao diagnóstico. O escore global de saúde avaliado pelo EORTC QLQ-30 foi de 67,5% e cerca de 63% dos pacientes apresentaram um status de Karnofsky de 80%. O fator influente mais positivo na capacidade funcional foi a função de trabalho (R = 0,515, p <0,05). Além disso, funções emocionais e sociais estavam fortemente associadas ao estado global de saúde dos pacientes (R = 0,960, p <0,05). Nossos dados mostraram que a escala de desempenho de Karnofsky é uma ótima ferramenta para avaliar a qualidade de vida em pacientes com câncer submetidos a quimioterapia, que se correlaciona positivamente com seus escores globais de saúde e é afetada pelas funções emocionais e sociais dos pacientes.

A 60-year-old man developed, within a month, right thoracic pain, shortness of breath and weight loss. He had a history of working in a metallurgical company and was exposed to chemical paints. He was admitted into the emergency department and a chest computed tomography revealed a large solid mass at the left superior lung lobe, measuring 80 mm x 40 mm. A biopsy was performed and confirmed the diagnosis of Lung Adenocarcinoma. Cancer staging was performed and revealed liver, bone and brain metastases. The brain magnetic resonance imaging disclosed several metastatic lesions at the right postcentral gyrus, occipital lobes and both cerebellar hemispheres. He underwent whole brain radiation therapy and received five cycles of palliative chemotherapy (carboplatin in combination with paclitaxel, and gemcitabine in combination with cisplatin). A second biopsy was performed at the liver metastasis, to search for possible targeted therapies. The results came positive for Epidermal Growth Factor Receptor (EGFR) exon 19 deletion, and an anti-EGFR was prescribed. The patient was started on Osimertinib, 80 mg once a day. The one year follow up showed great response and good drug tolerance, with an important improvement of muscle strength, asthenia and sensory deficits. The patient became fully ambulatory with a Karnofsky Performance Status Scale score of 90 and on the Neurologic Assessment in Neuro-Oncology Scale a score of 3 out of 23. Imaging studies revealed a smaller number of brain metastatic lesions, with decreased contrast enhancement. Therefore, the patient has had a dramatic response to the targeted therapy, both clinical and imaging. Targeted therapy is a growing field in neuro-oncology, leading us to an era of personalized medicine and tailored treatments, with great improvement in overall survival and quality of life. Unfortunately, in Brazil targeted therapies are still not widely available, due to high costs.

Objective: The aim of this study was to assess the therapeutic effects of Jianpi Liqi decoction (JPLQD) in hepatocellular carcinoma (HCC) and explore its underlying mechanisms. Methods: The characteristics and outcomes of HCC patients with intermediate stage B who underwent sequential conventional transcatheter arterial chemoembolization (cTACE) and radiofrequency ablation (RFA) only or in conjunction with JPLQD were analysed retrospectively. The plasma proteins were screened using label-free quantitative proteomics analysis. The effective mechanisms of JPLQD were predicted through network pharmacology approach and partially verified by ELISA. Results: Clinical research demonstrated that the Karnofsky Performance Status (KPS), traditional Chinese medicine (TCM) syndrome scores, neutropenia and bilirubin, median progression-free survival (PFS), and median overall survival (OS) in HCC patients treated with JPLQD were superior to those in patients not treated with JPLQD (all P&lt;0.05). The analysis of network pharmacology, combined with proteomics, suggested that 52 compounds targeted 80 potential targets, which were involved in the regulation of multiple signaling pathways, especially affecting the apoptosis-related pathways including TNF, p53, PI3K-AKT, and MAPK. Plasma IGFBP3 and CA2 were significantly up-regulated in HCC patients with sequential cTACE and RFA therapy treated with JPLQD than those in patients not treated with JPLQD (P&lt;0.001). The AUC of the IGFBP3 and CA2 panel, estimated using ROC analysis for JPLQD efficacy evaluation, was 0.867. Conclusion: These data suggested that JPLQD improves the quality of life, prolongs the overall survival, protects liver function in HCC patients, and exhibits an anticancer activity against HCC. IGFBP3 and CA2 panels may be potential therapeutic targets and indicators in the efficacy evaluation for JPLQD treatment, and the effective mechanisms involved in the regulation of multiple signaling pathways, possibly affected the regulation of apoptosis.